Stroke prevention: What's new?

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Antithrombotic treatment has now been joined by other evidence-based drug interventions for prevention of stroke, including angiotensin-converting enzyme inhibitors and hydroxymethylglutaryl-CoA reductase inhibitors. The efficacy of oral anticoagulation in atrial fibrillation has not been seen in other stroke-prone groups, although trials are continuing. Diffusion-weighted magnetic resonance imaging improves diagnostic accuracy in acute stroke, which is important in arriving at the right secondary prevention strategy. Carotid endarterectomy has been shown to be beneficial for 50-69% symptomatic stenosis but with a much narrower therapeutic index than for 70-99% stenosis. A comparison of endarterectomy with angioplasty and/or stent placement has been the subject of one small trial suggesting similar procedural stroke and mortality risks. Device closure of cardiac abnormalities increases in the absence of any trial data, and in spite of a low subsequent stroke risk for young patients with isolated patent foramen ovale treated with aspirin.

Original languageEnglish
Pages (from-to)177-181
Number of pages5
JournalInternal Medicine Journal
Issue number4
Publication statusPublished - 1 Apr 2003
Externally publishedYes


  • Angiotensin-converting enzyme inhibitors
  • Aspirin
  • Cerebrovascular disorders
  • Clopidogrel
  • HMG-CoA reductase inhibitors

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